title: Impact of the day-30 screening strategy on the disease presentation and outcome of retinopathy of prematurity. The Indian twin cities retinopathy of prematurity report number 3.
abstract: BACKGROUND
  Outcomes of various screening strategies in retinopathy of prematurity are not well reported.
  
  
  OBJECTIVE
  To assess the impact of a city-wide, ROP screening strategy, on the disease presentation and treatment outcome.
  
  
  METHODS
  A retrospective case-control study from a prospectively collected ROP data-base was analyzed. Cases (group 1a) included ROP babies that were screened directly in neonatal intensive care units, and controls (group 1b) were babies referred directly to the institute from other neonatal centers during the same period. Historical controls (group 2) were ROP cases seen in the years preceding establishment of this ROP program and database. Primary outcome measure was the risk of eyes presenting with stage 4 or worse ROP, and main secondary outcome measure was the final anatomic outcome.
  
  
  RESULTS
  Of the 643 cases screened, 322 eyes of 161 babies had ROP. The median age of 7.19 months at presentation for the 46 patients (92 eyes) in group 2 was higher than the median age of 1.29 months for the 115 patients (230 eyes) in group 1. Within the group 1, group 1a had lower median age at presentation than group 1b (0.91 months versus 2.30 months). The relative risk of an eye presenting in the stage 4 and 5 in group 2 was 4.7 times higher (95% confidence interval 3.07 -7.32) than in group 1. Eyes that could be given treatment in group 2 were significantly less (P < 0.0005) than in group 1. The relative risk of poor outcome in group 2 was 3.83 times higher (95% confidence interval 2.75 -5.34) than in group 1. Group 1a eyes had the best outcomes.
  
  
  CONCLUSIONS
  Early screening before one month of age in neonatal centers detects the disease early where prompt treatment can lead to favorable outcomes. The study provides early results of a model strategy for ROP screening.
authors.affiliation: Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Subhadra
authors.initials: S
authors.lastname: Jalali
authors.forename: Raj
authors.initials: R
authors.lastname: Anand
authors.forename: Padmaja Kumari
authors.initials: PK
authors.lastname: Rani
authors.forename: Divya
authors.initials: D
authors.lastname: Balakrishnan
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D008403:Mass Screening / Q000592:standards*; D017410:Practice Guidelines as Topic; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D014505:Urban Population